Schizophrenia Explained: Causes, Symptoms, and the Path to Healing

Schizophrenia Explained: Causes, Symptoms, and the Path to Healing

Schizophrenia is a chronic and severe mental disorder that affects how a person thinks, feels, and behaves. This blog explores deep into schizophrenia, including its causes, types, symptoms, and treatments. Read the following blog to learn more.

What is Schizophrenia?

Schizophrenia is a psychotic disorder characterized by distorted thinking, perception, emotions, language, sense of self, and behavior. People with schizophrenia may experience delusions, hallucinations, disorganized speech, and/or impaired cognitive ability. In the United States, approximately 1.1% of the population, or about 2.8 million adults, are estimated to have schizophrenia. Around 40%,may be untreated. Globally, an estimated 24 million people, or 1 in 300 individuals, are affected by schizophrenia.

What Causes Schizophrenia?

There is no single cause of schizophrenia. Instead, it likely results from a combination of genetic, biological, and environmental factors.

·       Genetic Factors- Individuals with a family history of schizophrenia are at higher risk. However, having a relative with the disorder does not guarantee someone will develop it.

·       Biological Factors- Imbalances in neurotransmitters, especially dopamine and glutamate, may contribute. Levels of neurotransmitters that are too high or too low are known to impact cognitive disorders. Brain scans have shown that some individuals with schizophrenia have differences in brain structure, such as enlarged ventricles.

·       Enviormental Factors- Prenatal exposure to infections or malnutrition. Complications during birth, such as lack of oxygen. Stressful life events or trauma in early childhood.

Types of Schizophrenia

Although the official subtypes have been removed from the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), in the past, here are the categories that people would be diagnosed into based on their symptoms.

1. Paranoid Schizophrenia

·       Dominated by delusions and auditory hallucinations, often involving themes of persecution or conspiracy.

·       Thinking and speech may remain organized.

2. Disorganized (Hebephrenic) Schizophrenia

·       Characterized by disorganized thinking, speech, and behavior.

·       Flat or inappropriate emotional responses.

3. Catatonic Schizophrenia

·       Involves extreme motor behavior, from rigid posturing to excessive movement.

·       May include periods of not speaking or responding.

4. Undifferentiated Schizophrenia

·       Symptoms don’t fit neatly into other types but still meet the criteria for schizophrenia.

5. Residual Schizophrenia

·       Individuals may no longer exhibit active symptoms but still experience some negative symptoms, like low motivation or reduced speech.

The two main types of schizophrenia are:

Acute Schizophrenia- An acute episode of schizophrenia is a period of intense psychotic symptoms that can last from days to months. During an acute episode, individuals may experience hallucinations (seeing, hearing, smelling, tasting, or feeling things that aren't there), delusions (fixed, false beliefs), disorganized thinking and speech, and bizarre behaviors. Acute episodes can be sudden and severe, often triggered by life events or stress. They can be followed by a period of remission, where symptoms lessen, or they may lead to the development of chronic schizophrenia. Acute episodes typically require immediate treatment, often involving antipsychotic medications and other therapies to stabilize symptoms.

Chronic schizophrenia- A long-lasting condition characterized by persistent symptoms and functional impairment. While positive symptoms like hallucinations and delusions may still be present, negative symptoms (e.g., flat affect, social withdrawal, anhedonia) tend to become more prominent over time. Chronic schizophrenia is often characterized by recurring acute episodes and periods of remission, but the overall level of functioning tends to decline. Chronic schizophrenia requires ongoing treatment, including medications, psychotherapy, and social skills training to manage symptoms, improve functioning, and prevent further decline.

Symptoms of Schizophrenia

Symptoms of cognitive disorders are typically divided into three categories: positive (something was added, not necessarily a “good thing”), negative (something was taken away/removed, not necessarily a “bad thing”), and cognitive. The following are some examples of symptoms related to schizophrenia.

Positive Symptoms of Schizophrenia (Adding something not normally present)-

·       Hallucinations- Sensory experiences (seeing, hearing, smelling, tasting, or feeling) that seem real but are not actually there. These hallucinations can affect any of the five senses and are often vivid and clear, but they occur when the person is fully awake and alert. They are a common symptom of schizophrenia, experienced by a significant percentage of individuals with the disorder. 

·       Delusions- A firmly held false belief that is not based in reality, and which the person is convinced is true despite evidence to the contrary. These beliefs are so deeply ingrained that they are resistant to change, even when presented with factual evidence that contradicts them.

·       Disorganized speech- A symptom characterized by abnormal patterns in speech and communication that often make it difficult for others to understand the individual. This symptom is a manifestation of disorganized thinking and can include difficulties with coherence, logical flow, and the ability to follow a conversation. 

·       Bizarre behaviors- Disorganized thinking and speech that are unusual, erratic, or inappropriate given the social context. It's one of the key features of the illness, particularly in what was formerly known as disorganized schizophrenia

Negative Symptoms (Taking away normal function)

·       Lack of motivation- A diminished drive or inability to initiate and maintain goal-directed behaviors. It goes beyond simply being lazy and reflects a significant difficulty in pursuing everyday tasks and activities.

·       Reduced emotional expression- flat affect (showing no emotion)

·       Social withdrawal- A reduction or avoidance of social interaction, often accompanied by indifference, detachment, or aloofness.

·       Inability to experience pleasure- anhedonia

Cognitive Symptoms

·       Poor executive functioning- difficulty in planning or decision-making

·       Trouble focusing or paying attention

·       Memory issues

Treatments for Schizophrenia

Schizophrenia requires long-term treatment, usually a combination of medication, therapy, and community support.

Medications

·      Antipsychotic medications are the cornerstone of treatment used to treat many people with schizophrenia (First-generation: Haloperidol, Chlorpromazine / Second-generation (atypical): Risperidone, Olanzapine, Clozapine). These help reduce symptoms like hallucinations and delusions.

Psychotherapy

·       Cognitive Behavioral Therapy (CBT)- Helps patients manage symptoms and cope with stress.

·       Family therapy- Educates families and provides support.

·       Supportive therapy- Builds social and communication skills.

3. Rehabilitation and Support Services

·       Vocational training and job placement programs

·       Social skills training

·       Housing and community support programs

4. Hospitalization

·       May be necessary during severe episodes to ensure safety and provide intensive treatment.

Citations:

APA, “What Is Schizophrenia?” Psychiatry.Org - What Is Schizophrenia?, 2024, www.psychiatry.org/patients-families/schizophrenia/what-is-schizophrenia#:~:text=Schizophrenia%20is%20a%20chronic%20brain,thinking%20and%20lack%20of%20motivation

Staff, Mayo Clinic. “Schizophrenia.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 16 Oct. 2024, www.mayoclinic.org/diseases-conditions/schizophrenia/symptoms-causes/syc-20354443

Mental Health, NIH. “Schizophrenia.” National Institute of Mental Health, U.S. Department of Health and Human Services, 2023, www.nimh.nih.gov/health/topics/schizophrenia